AIMatMelanoma.org
en fr de es it iw el nl da fi sv no pl ru cs

Diagnosis and Treatment Options for Brain Metastases

Tests for Brain Metastases

Several types of brain scans can be used to diagnose melanoma brain metastases, including CT scans, MRI, or PET scans.

 

For more about imaging studies click here.

 Symptoms to Watch Out For

Specific neurologic signs and symptoms might indicate brain metastases. These include headache, muscle weakness, and behavioral changes such as changes in judgment and reasoning.  Physical problems can include vision changes, hearing loss, dizziness, nausea or vomiting, language disturbances, difficulty walking, and seizures.

If you have been diagnosed with melanoma and have any of these symptoms, you should contact your medical oncologist as soon as possible,

Treatments Options for Melanoma Brain Metastases

Currently, treatment options for brain metastases depend on the number of metastases, their size and location, the presence of extracranial (outside of the skull) disease control of the primary cancer, and performance status of the patient.

.

Treatment Goal Comments
Surgery

Well-established and a standard treatment for melanoma brain metastases.

Is potentially curative

 Usually reserved for patients with < 3 brain metastases. Patients with many tumors or tumors in critical areas of the brain are usually not candidates for surgery.
Radiation SRS (stereotactic radiosurgery) focuses on certain spots in the brain. One newer type, gamma knife, is able to treat metastases more quickly than previous radiation machines. SRS can result in long-term control of brain metastases for some patients. An alternative to surgery for patients with <3 brain metastases. At some centers, gamma is used to treat more than 3 brain metastases.

WBXRT (whole-brain radiation treatment) treats brain metastases that can be seen as well as tumor cells that are too small to be identified by MRI or CT scans. WBXRT is likely to slow the growth of tumors, but it is generally not thought to be curative

 Typically used in patients who have too many brain metastases to be suitable for surgery or SRS.
Chemotherapy   Drugs such as temozolomide are able to get into the brain tissue and are frequently used to treat patients with brain metastases.

 

While these therapies may provide dramatic responses in some patients, they can only slow the growth of tumors in the brain; they are not curative. The majority of tumors will eventually start to grow again.

 Most standard chemotherapy drugs cannot penetrate the blood-brain-barrier and therefore have no effect on brain tumors.
Supportive Care Designed to reduce pain, confusion, and/or seizures but not intended to slow or eliminate the growth of the tumors. Steroids (ie dexamethasone) are frequently used to reduce swelling in the brain caused by metastases, which may help ease symptoms of pain and confusion. Often used when the physician feels that active treatment will do more harm than good, or it is the patients' preference not to be treated.